Inguinal mass due to an external supravesical hernia and acute abdomen due to an internal supravesical hernia: A case report and review of the literature

Abstract

Although supravesical hernias were described as early as 1804, there have been fewer than 100 cases reported in the literature. The supravesical fossa is a triangular area bounded laterally and above by median and medial umbilical ligaments, and below by the peritoneal reflection that passes from the anterior abdominal wall to the dome of the bladder. A hernia starting in this fossa usually protrudes through the abdominal wall as a direct inguinal hernia (external supravesical hernia). Less commonly, it remains within the abdomen, passing into spaces around the bladder (internal supravesical hernia). A 43-year-old mill worker presented with an enlarged painful mass in the left groin. He underwent a surgical repair of a direct inguinal hernia without addressing an unrecognized supravesicular component. Eight hours after his discharge next morning, he presented with acute abdomen, nausea, vomiting, and abdominal distention. The second surgery revealed the presence of a left lateral internal supravesical hernia with incarcerated small bowel. This was also repaired, and the patient was discharged in stable condition. This report aims to review and discuss the surgical anatomy of these rare supravesical hernias and calls attention to this type of hernia as an unusual cause of small bowel obstruction.

Laparoscopic repair of a supravesical hernia presenting as a ‘recurrent’ inguinal hernia in a 5‐year‐old female

“…The first description of external supravesical hernia is traditionally ascribed to Astley Cooper in 1804 . Since that time, there have been fewer than 100 reports in the adult literature . This is the first report of such a hernia in a paediatric patient.…”

Obstrucción intestinal debido a hernia estrangulada en el espacio prevesical: presentación de un caso y revisión de la literatura

“…La hernia en el espacio prevesical o espacio de Retzius se localiza, como su propio nombre indica, en esta región, más concretamente en la fosa supravesical. Esta es un área triangular relacionada lateralmente y por encima con los pliegues umbilicales laterales que cubren las arterias hipogástricas obliteradas y, por debajo, adherida a una reflexión peritoneal que se extiende desde la pared abdominal anterior hasta el fundus vesical 1 .…”

“…Las hernias asentadas en esta localización se forman como resultado de un fallo en la integridad de la aponeurosis del músculo transverso y la fascia transversalis y normalmente protuyen hacia la pared abdominal como una hernia inguinal directa (hernia supravesical externa). Sin embargo, raramente, protuyen hacia el abdomen (hernia supravesical interna) 1,[2][3][4] .…”

Laparoscopic repair of a bilateral internal inguinal hernia with supravesical hernia – a case report

“…Supravesical hernia is located between the median umbilical ligament and the medial umbilical ligament, and it is classified as two types: internal supravesical hernia and external supravesical hernia. Patient with supravesical hernia, especially internal supravesical hernia, have a risk for the development of incarcerated and intestinal obstruction, and external supravesical hernia present inguinal protrusion [3–9] . It was also reported that patients with supravesical hernia presented with bladder symptoms such as frequent urination [10] .…”